Growing up in the small town of Breaux Bridge, La., Kylar Wiltz, a third-year medical student at Howard University College of Medicine, didn’t see doctors who looked like him. In fact, he didn’t see a Black physician until he was an adult, but he’s working to change that for the next generation.
In August, Wiltz went back to his hometown to support a school-supply giveaway for elementary school students from his old neighborhood. He was struck by the children’s surprise that someone from their neighborhood was becoming a doctor, and their reaction is at the heart of why he plans to return home someday to practice.
“I need to be what I wish I had seen growing up,” Wiltz said during a recent panel at the Congressional Black Caucus Foundation’s Annual Legislative Conference in Washington, D.C.
Indeed, seven years after the AAMC (Association of American Medical Colleges) raised the alarm about the paucity of Black men in medicine in its report, “Altering the Course: Black Males in Medicine,” their numbers remain distressingly low.
In this 2015 report, the AAMC found that the number of Black male medical students had actually declined over the previous four decades years — from 542 in 1978 to just 515 in 2014. What’s more, the numbers have continued to fall. A 2021 study published in The New England Journal of Medicine found that Black men in 2019 represented just 2.9 percent of the medical student body, down from 3.1 percent in 1978.
Why does this matter? Studies have found that patients who are treated by physicians of the same race or ethnicity are more likely to follow the physician’s recommendations for medication or preventive screenings, and in some contexts, health outcomes are dramatically improved.
The COVID-19 pandemic highlighted the deep inequities embedded in our nation’s health care system. We continue to believe that diversifying the health care workforce will be critical to addressing these inequities. But we have no time to lose. It takes at least seven years of training to become a physician — but it will take even more time to rectify some of the systemic issues that lead to so few Black men even applying to medical school.
These issues include a lack of sufficient funding for K-12 schools in under-resourced communities, the need for interventions to address the achievement gap for Black boys and the scarcity of dedicated programs to mentor and guide medical school applicants from underrepresented and marginalized backgrounds.
The Health Resources and Services Administration (HRSA) Title VII workforce development programs, under the U.S. Department of Health and Human Services (HHS), are crucial in training a diverse and culturally competent health care workforce. HRSA Title VII programs invest in scholarship, loan repayment, mentorship and community-driven K-16 health outreach and education programs for future health care professionals from underrepresented minority, rural, and disadvantaged backgrounds. But these programs are chronically underfunded.
We also must ensure equitable access to federal student aid and loan repayment programs for all medical students and residents, particularly any Black men without the financial resources to apply to or attend medical school. The AAMC has endorsed legislation to establish a “Pathway to Practice” program that would help address the burden of medical education debt for students from underrepresented backgrounds and support their medical residency training.
The underrepresentation of Black men in medicine is an issue that requires attention and support from federal programs, as well as significant focus from the academic medicine, K-12, philanthropic and youth development sectors. To that end, the AAMC and the National Medical Association (NMA), the oldest organization of Black physicians, have formed the Action Collaborative for Black Men in Medicine to convene like-minded partners from across sectors to learn about, align and integrate our actions to achieve systems-level change that will produce more Black men in medicine. The inaugural Strategy Summit with leaders from across the nation took place last week in Washington, D.C. The work will continue long after.
Our efforts are aimed at removing barriers to a physician workforce that more accurately reflects the diversity of America. While Wiltz was the first Black medical student that many of the youth from his hometown had ever encountered, he cannot be the last. Every child who dreams of being a doctor should have the opportunity to see a pathway into medicine, no matter their race or ethnicity.
The health of our communities and our nation depends on it.
David Acosta, MD, is the chief diversity and inclusion officer at the Association of American Medical Colleges. Garfield Clunie, MD, is president of the National Medical Association.